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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343614216
Report Date: 06/21/2023
Date Signed: 06/21/2023 02:47:07 PM


Document Has Been Signed on 06/21/2023 02:47 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:CATALYST KIDS - JOHN EHRHARDTFACILITY NUMBER:
343614216
ADMINISTRATOR:LEON-MARTINEZ, ANTOINETTEFACILITY TYPE:
850
ADDRESS:8900 OLD CREEK DRIVETELEPHONE:
(916) 684-1815
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY:21CENSUS: 6DATE:
06/21/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Antoinette Leon-MartinezTIME COMPLETED:
04:00 PM
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Licensing Program Analyst Katy Maestas (LPA) conducted a field visit to the facility for the purpose of an unannounced annual inspection. LPA disclosed the purpose of the inspection and was granted entrance into the facility. LPA met with the Director Antoinette Leon-Martinez (D1). LPA toured the facility inside and outside. LPA observed 6 preschool aged being supervised by 1 staff member. LPA accessed Guardian to verify that all required adults were background cleared. LPA observed that hazardous items (disinfectants, cleaning solutions etc.) were inaccessible to children in care. Facility days and hours of operation are Monday-Friday from 7:00 AM to 6:00 PM. The facility provides breakfast, lunch and snack which is supplied by the facility.

LPA conducted a file review prior to inspection and verified that annual fees were current. While on location, LPA reviewed care and supervision of children, staffing ratios, medications, first aid supplies, furniture, equipment, fire drills, and drinking water. LPA observed all required forms to be posted. There appear to be adequate toys and equipment available for children. LPA toured the outdoor play area, and the play structure for ages 2-5 years old appeared to be in good repair. LPA observed wood chips providing sufficient cushioning under the play structure to prevent injury.

LPA reviewed the sign in/out documents on the facility's app and observed that the children in attendance were signed in. LPA reviewed children’s and staff files. LPA observed Health Screening Reports with TB test and required MMR and TDAP vaccines for all staff members who were present. At least one staff member present today had current Pediatric CPR and First Aid (exp. 01/2025). LPA observed current Mandated Reporter training for all staff. D1 was reminded to renew the course every 2 years. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/. The training is currently provided in English and Spanish.
Report continues on 809-C
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Nola MaestasTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:
DATE: 06/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/21/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CATALYST KIDS - JOHN EHRHARDT
FACILITY NUMBER: 343614216
VISIT DATE: 06/21/2023
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This facility provides Incidental Medical Services (IMS). LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

The Facility has COMPLETED TESTING WITH NO LEAD EXCEEDANCES: Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5 years after the date of the first test. For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP.

D1 was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

L1 was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Report continues on 809-C

SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Nola MaestasTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2023
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CATALYST KIDS - JOHN EHRHARDT
FACILITY NUMBER: 343614216
VISIT DATE: 06/21/2023
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

In the areas that were evaluated today on 06/21/2023, one Type B deficiency was cited on a subsequent 809-D page. LPA conducted an Exit Interview and the report was reviewed with D1. A Notice of Site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Nola MaestasTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 06/21/2023 02:47 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827


FACILITY NAME: CATALYST KIDS - JOHN EHRHARDT

FACILITY NUMBER: 343614216

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 06/21/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101220(a)
Child's Medical Assessments
(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and LPA observation, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/05/2023
Plan of Correction
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Licensee Representative will create a letter which states that the Health Screening form, with a doctor's signature, is a requirement for enrollment. In addition, the letter will explain that the child will be disenrolled from the program if the form is not sbmitted to the facilty within 30 days of the child's first day of enrollment. This letter will be attached to a Health Screening form and distributed to all current students for future enrollment as well as all prospective children for future enrollment. The letter will be emailed to LPA Maestas by no later than 07/05/2023.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Nola MaestasTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:
DATE: 06/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/21/2023
LIC809 (FAS) - (06/04)
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